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LOGIN TO MYCHART
Axis Community HealthAxis Community Health
Axis Community HealthAxis Community Health
  • Home
  • Become A Patient
    • Enrollment
    • New Patient Resources
  • Patient Services
    • MyChart Patient Portal
    • Medical Clinic
      • Medical Providers
      • Adult & Geriatric Medicine
      • Pediatrics
      • Immunization & Flu Shots
      • Reproductive Health Services
        • Prenatal Care & Obstetrics
        • Pregnancy Tests
      • Clinical Nutrition
      • Colon Cancer Screenings
      • Remote Patient Monitoring
    • Acupuncture
    • Chiropractic
    • Dental
    • Mental Health
      • Behavioral Health Directory
      • Counseling Services
      • Addiction Counseling
      • Community-Based Counseling
      • Axis Bridge Mental Health Urgent Care
    • WIC Nutritional Services
  • Donations
    • Donate to Axis
    • New Livermore Clinic
  • About Us
    • Our Mission
    • Contact Us
    • Locations & Directions
      • Info on New Livermore Clinic
    • Hours of Operation
    • Board of Directors
    • Leadership
    • Jobs & Volunteering
    • Notice of Privacy Policy
    • FAQ
  • Resources
    • Food Resources
    • Community Resources
    • Patient Forms
  • Newsletter Sign-Up

NEW PATIENT FORMS AND INFORMATION

Welcome to Axis! We're glad you're here!

For questions and more information, please call 925.462.1755.

New Patient Forms

English | Spanish

In this packet you will find:

    • Acknowledgment of New Patient Information
    • Acknowledgment of Receipt of Notice Of Privacy Practices
    • Informed Consent for Treatment
    • Informed Consent for Behavioral Health
    • Informed Consent for Telehealth Appointments
    • Authorization for Release and/or Disclosure of Behavioral Health Information
    • Advance Health Care Directive

Printable New Patient Registration

English | Spanish

Click here for more patient forms!

What to bring to a new patient appointment:

    • Current medications and/or vitamins
    • Current insurance coverage cards
    • Previous medical records & doctor information
    • Immunization Records
    • Any legal medical paperwork including, advanced directives and guardianship

Access your MyChart Patient Portal

    • Communicate with your provider
    • Get reminders
    • Manage your appointments
    • Access your test results
    • View your medications and request refills
Login to MyChart

OUR MISSION
The mission of Axis Community Health is to provide quality, affordable, and compassionate health care services that promote the well-being of all members of the community.
_________________

Axis Community Health receives HHS funding and has Federal PHS deemed status with respect to certain health or health-related claims, including medical malpractice claims, for itself and its covered individuals.

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